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Optometrists, ophthalmologists perform comparably for detecting vision impairment

08 Feb 2021

Optometrists perform just as well as ophthalmologists for the correct identification of vision impairment, a recent study has found.

A pool of 30 consultant ophthalmologists and 99 low vision optometrists were asked to review 40 randomly selected anonymized case records. A consensus panel, consisting of four consultant ophthalmologists and three optometrists with formal accreditation in low vision, was then assembled to determine whether each case record satisfied the eligibility to be certified as sight impaired (SI).

Of the 40 records, the consensus panel found 15 to be eligible for SI certification, while 13 could be classified as being severely SI (SSI); the remaining 12 failed eligibility. All designations were reached through unanimous consensus.

In comparison, the surveyed ophthalmologists rated a median of 19 case records to be ineligible for certification, while optometrists classified 14 cases as ineligible. The respective groups of professionals identified SI in 11 and 17 case records, while SSI was detected in 10 and 8 records.

In the ophthalmologist groups, the median number of cases where the judgement was in agreement with the consensus panel was 33.0. This was higher among optometrists, who agreed with the panel in a median of 36.0 cases.

The most disagreement between optometrists and ophthalmologist occurred for case records that the consensus panel identified as eligible for SI. Where optometrists identified 72 percent of cases, ophthalmologists agreed only 52 percent of the time. Concordance between clinical groups was better for cases that were ineligible for vision impairment certification.

“Ophthalmologists and optometrists demonstrated an equivalent rating of cases for the certification of vision impairment. The evidence suggests that it is feasible for low vision optometrists to certify patients with atrophic age-related macular degeneration,” the researchers said.

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